CONNIE R PRUVOST Registered Nurse License verification

Business Entity

ACTIVE

License Type

Registered Nurse

Description

REGISTERED PROFESSIONAL NURSE

License Number

041256656

License Status

ACTIVE

Business

First Name

CONNIE

Middle

Last Name

PRUVOST

Business Name

CONNIE R PRUVOST

Original Issue Date

04/06/1990

Effective Date

03/01/2026

Expiration Date

05/31/2028

City

WASHINGTON

State

Zip

61571

County

TAZEWELL

Ever Disciplined

LastModifiedDate

03/01/2026